Why 90 % of cardiologists suffer from coronary blindness ?

Note :This is a copy of  my earlier blog on coronary micro-circulation  published few years ago.Recently this got numerous hits .Hence I have just reposted it with slight modification. Human coronary circulation stands unique among  others as it is a  life-sustaining circulation.It is indeed a great medical achievement  to visualise  the right and left coronary artery  system by coronary angiogram.  Actually,  what we see is  only a fraction  of  the surface area of coronary circulation .The surface area of  epicardial coronary arteries   constitutes  less than 5 % of entire coronary vascular tree . And  . . . An in vitro heart with special catheters showing the true extent of coronary circulation: Courtesy http://eurheartj.oxfordjournals.org/content/28/3/278.full.pdf+html This  is the reason  normal coronary angiogram can never mean normal  coronary circulation ! This huge gap in our perception is the single important factor  that  explains the vagaries  of modern coronary care . This also make any clinical coronary  scenario  a  reality . “A patient with normal coronary angiogram getting a myocardial infarction , the next day and a severe triple vessel disease living comfortably  for  decades with medical management” So , it is essentially a  false  sense of  scientific accomplishment  by the cardiac scientists  at  least in the  of coronary circulatory physiology. What determines the extent of these invisible coronary micro cir...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: cardaic physiology cardiac physiology Cardiology -Coronary collateral circulation Cardiology quotes coronary angiogram coronary blindness coronary micro circulation Source Type: blogs